Diagnosis: Cheney

Network News

"What is wrong with Dick Cheney?" asks Michelle Cottle in the inaugural issue of the newly relaunched New Republic. She then spends the next 1,900 words marshaling evidence suggesting that his cardiac disease has left him demented and mentally disordered.

The charming part of this not-to-be-missed article (titled "Heart of Darkness," no less) is that it is framed as an exercise in compassion. Since Cottle knows that the only way for her New Republic readers to understand Cheney is that he is evil -- "next time you see Cheney behaving oddly, don't automatically assume that he's a bad man," she advises -- surely the generous thing for a liberal to do is write him off as simply nuts. In the wonderland of liberalism, Cottle is trying to make the case for Cheney by offering the insanity defense.

She doesn't seem to understand that showing how circulatory problems can affect the brain proves nothing unless you first show the existence of a psychiatric disorder. Yet Cottle offers nothing in Cheney's presenting symptoms or behavior to justify a psychiatric diagnosis of any kind, let alone dementia.

What behavior does she cite as evidence of Cheney's looniness?

(a) Using a four-letter word in an exchange with Sen. Patrick Leahy. Good God, by that standard, I should long ago have been committed and the entire borough of Brooklyn quarantined.

(b) "Shoot a man in the face and not bother to call your boss 'til the next day?" Another way of putting that is this: After a hunting accident, Cheney tried to get things in order before going public. Not the best decision, as I wrote at the time, but perfectly understandable. And if that is deranged, what do you say about a young Teddy Kennedy being far less forthcoming about something far more serious -- how he came to leave a dead woman at the bottom of a pond? I am passing no judgment. I am simply pointing out how surpassingly stupid it is to attribute such behavior to mental illness.

(c) Longtime associate Brent Scowcroft quoted as saying, "Dick Cheney I don't know anymore." Well. After Sept. 11, 2001, Cheney adopted a view about fighting jihadism, America's new existential enemy, that differed radically from the "realist" foreign policy approach that he had shared a decade earlier with Scowcroft. That's a psychiatric symptom? By that standard, Saul of Tarsus, Arthur Vandenberg, Irving Kristol, Ronald Reagan -- to pick at random from a thousand such cases of men undergoing a profound change of worldview -- are psychiatric cases. Indeed, by that standard, Andrew Sullivan is stark raving mad. (Okay, perhaps not the best of counterexamples.)

I, too, know Dick Cheney. And I know something about the effects of physical illness on mental functioning. In my younger days, writing in the Archives of General Psychiatry, I identified a psychiatric syndrome ("Secondary Mania," the title of the paper) that was associated entirely with organic (i.e., underlying physical) disorders. The British medical journal Lancet found this discovery notable enough to devote an editorial to it and to alert clinicians to look for its presenting symptoms.

And as a former chief resident of the psychiatric consultation service at Massachusetts General Hospital -- my house staff and I were called in to diagnose and treat medical inpatients (many of them post-op, many with cardiac disease) who had developed psychiatric symptoms -- I know something about organically caused dementias. And I know pseudoscientific rubbish when I see it.

I was at first inclined to pass off Cottle's piece as a weird put-on -- when people become particularly deranged about this administration, it's hard to tell -- but her earnest and lengthy piling on of medical research about dementia and cardiovascular disease suggests that she is quite serious.

And supremely silly. Such silliness has a pedigree, mind you. It is in the great tradition of the 1964 poll of psychiatrists that found Barry Goldwater clinically paranoid. Goldwater having become over the years the liberals' favorite conservative (because of his libertarianism), nary a word is heard today about him being mentally ill or about that shameful election-year misuse of medical authority by the psychiatrists who responded to the poll. The disease they saw in Goldwater was, in fact, deviation from liberalism, which remains today so incomprehensible to some that it must be explained by resort to arterial plaques and cardiac ejection fractions.

If there's a diagnosis to be made here, it is this: yet another case of the one other syndrome I have been credited with identifying, a condition that addles the brain of otherwise normal journalists and can strike without warning -- Bush Derangement Syndrome, Cheney Variant.